Hernandez, Kathy Susan

Hernandez, Kathy Susan is an individual health care provider with primary practice located at 1032 S Cesar E Chavez Dr , Milwaukee WI 53204-2203. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Hernandez, Kathy Susan can be contacted via phone (414) 672-1353.

Contact Information

Primary practice address
1032 S Cesar E Chavez Dr Milwaukee WI 53204-2203
Fax: (414) 672-4265
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 32458 Wisconsin

Profile Details

NPI number 1164427654
LBN Legal business name Hernandez, Kathy Susan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164427654 NPPES
Wisconsin MEDICAID 31735400
Wisconsin Other 810127286
Wisconsin Other 4654337
Wisconsin Other 3596782

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